I kick of the news this week with a study conducted recently and published in Prehospital Emergency Care on whether or not Ohio paramedics can recognize STEMI rhythms when presented with them. In the study, paramedics from Ohio were given ten cardiac rhythm 12-leads to read and identify the underlying rhythm and the presence or absence of STEMI.
Recognition of STEMI ECG Not Good
The strips were from actual patients transported to Summa Akron City Hospital. Among the rhythms in the strips were an inferior STEMI, an anterior STEMI, a lateral STEMI, a paced rhythm, an SVT rhythm, an ECG showing LVH, a left and right bundle branch block, and two normal ECGs. In the past, STEMI accuracy by paramedics has been studied by post-call chart review and not by direct surveys like this one.
The results were not stellar. While the majority correctly identified the Inferior and Anterior STEMIs (96% and 78% respectively), only about half were able to recognize the lateral STEMI. As the article’s discussion on the study says, this is not the level of accuracy we’d like to see or are used to seeing in STEMI recognition in the field by experienced EMS providers and the reviewers question whether the strips in the survey were “difficult ECGs” or not when compared to machine-generated rhythm strips.
Still the point I think we need to bring up is that there is a reason that we all have regular education requirements and have a professional responsibility to regularly practice and review our skills like reading ECGs. Don’t cut corners. Take some time on a regular basis to review strips. Ask your ED docs to save interesting strips and quiz you when you come in for education or even just in passing. Let’s continue to raise the bar on what we expect from ourselves.
Follow-up on the link for this and other news items as well as all of the additional resource links in the show notes for this episode – Acetyl Fentanyl and Fentanyl Overdoses and Episode 370.